Laparoscopic proctocolectomy with ileal pouch-anal anastomosis

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Conventional open proctectomy and ileal pouch-anal anastomosis have established outcomes.
• Laparoscopic techniques are increasingly explored as alternatives to open surgery.
• Limited data exists on extensive laparoscopic proctocolectomy series.

Purpose of the Study:

• To present the experience of laparoscopic proctocolectomy with ileal pouch-anal anastomosis.
• To evaluate the safety and feasibility of this minimally invasive approach.
• To assess outcomes in patients with ulcerative colitis and familial adenomatous polyposis.

Main Methods:

• Laparoscopic proctocolectomy with ileal pouch-anal anastomosis performed on 23 patients.
• Minimally invasive technique with a small flank incision for exteriorization and pouch formation.
• All other surgical steps were completed laparoscopically.

Main Results:

• No intraoperative complications or conversions to open surgery were reported.
• Median operative time was 315 minutes, with average blood loss of 130 mL.
• Postoperative complications occurred in 22% of patients, with no surgical reinterventions required. Median hospital stay was 9 days.

Conclusions:

• Laparoscopic proctocolectomy with ileal pouch-anal anastomosis is technically feasible and safe.
• The laparoscopic approach offers potential benefits such as improved cosmesis and reduced blood loss.
• This technique is suitable for patients with familial adenomatous polyposis and ulcerative colitis.